Objective To investigate the relationship between Oxfordshire community stroke project (OCSP) classification and MRI classification in acute cerebral infarction. Methods A total of 282 patients with acute cerebral infarction were retrospectively evaluated with OCSP classification and imaging characteristics. Results According to OCSP classification, of all 282 patients with acute cerebral infarction, 32 (11.3%) experienced total anterior circulation infarction (TACI), 86 (30.5%) partial anterior circulation infarction (PACI), 111 (39.4%) lacunar infarction (LACI), and 53 (18.8%) posterior circulation infarction (POCI). The consistency was found in 201 cases (71.3%) between the OCSP classification and imaging classification, with the accuracy of 77% (27/35) for TACI, 79% (42/53) for PACI, 69% (95/137) for LACI and 65% (37/57) for POCI. Conclusion OCSP classification can predict the location and size of cerebral infarction with a high accuracy, and is well consistent with the MRI findings.
Integrated traditional Chinese and Western medicine has been used to treat acute pancreatitis (AP) for more than 50 years. It has become a dominant and specialized disease treated by integrated traditional Chinese and Western medicine. After many years of clinical practice, a relatively mature and complete treatment system has been formed. Therefore, it was proposed by the Chinese Society of Integrated Traditional Chinese and Western Medicine, the Chinese Medical Association, and the Chinese Association of Traditional Chinese Medicine to update and formulate the “Guidelines for the Diagnosis and Treatment of Acute Pancreatitis with Integrated Traditional Chinese and Western Medicine” (2021) group standards in 2022, and “Integrated Traditional Chinese and Western Medicine Practice Guidelines for Diagnosis and Treatment of Acute Pancreatitis” finally published. The guideline condenses 25 kinds of important clinical issues, which guide to explain the diagnosis and treatment of AP in detail, focusing on the integration of traditional Chinese medicine and Western medicine in the management of AP, such as staging and syndrome differentiation, early fluid therapy, pain management, and organ function support in early stage. The advantages and the timing of early intervention of traditional Chinese medicine in AP are emphasized. This guideline also proposes suggestions on nutritional support, management of causes, treatment of late local complications and infections, as well as prevention of recurrence and follow-up strategies for long-term complications. This paper provides an interpretation of this guideline.
Objective The baseline, clinical characteristics, and risk factors were analyzed in the stroke registry program of the Xinjiang Production Constraction Corp’s Hospital aimed to aid the clinical management and stroke prevention. Method A single center prospective method based on Lausanne Stroke Registry was used in this study. Patients generally, past history, living conditions, onset to treatment time, the stroke scale were collected with 1 year follow up. The investigators of follow up were single blinded. Result Eight hundred and ten ischemic stroke patients were included, of which 478 (59.01%) were male, 332 (40.99%) were female. The average age of these patients was 66.50±10.66 years. One year loss rate of follow up was 4.64%. Seven hundred and sixty-nine patients were diagnosis as acute cerebral infarction, 41 patients were TIA. The median time from onset to treatment was 15 hours. Lacunar infarction was the most common type with 334 (43.43%) patients. The average score of the National Institutes of Heath Stroke Scale was 5.55±7.24. The incidence of carotid artery plaque was 82.2%. Conclution Xinjiang region has its own characteristics of stroke with a higher carotid artery plaque rate and thrombolytic therapy ratio. Good stroke registration system could standardize the clinical behavior and promote the continuous improvement of medical quality.
Objective To analyze the efficacy of music therapy on the rehabilitation of post-stroke cognitive impairment (PSCI) and to provide a reference for rehabilitation intervention methods for PSCI. Methods Patients hospitalized in Beijing Bo’Ai Hospital, China Rehabilitation Research Center and diagnosed with PSCI between December 2020 and July 2022 were prospectively selected. According to the random number table method, patients were divided into a music therapy group and a control group. Both groups were given conventional neurology medication, nursing care, and conventional rehabilitation. The music therapy group received additional music therapy training, and both groups received treatment for one month. The Montreal Cognitive Assessment (MoCA), National Institute of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment Scale (FMA), and modified Barthel Index (MBI) were used before and after treatment to assess patients’ cognitive function, degree of neurological deficits, motor function and activities of daily live. Results A total of 48 patients were included, with 24 patients in both groups. There was no statistically significant difference in gender, age, education level, stroke type, lesion location, comorbidities, history of myocardial infarction or peripheral vascular disease, and smoking status between the two groups of patients (P>0.05). Before and after treatment, most patients in the two groups did not score in terms of language and delayed recall scores, and the difference were not statistically significant (P>0.05). There was no statistically significant difference in MoCA scores, visual space and executive function, naming, attention, calculation, abstract thinking, and orientation scores between the two groups of patients before treatment (P>0.05). After treatment, the MoCA score, visual space and executive function, naming, attention, calculation, abstract thinking, and orientation scores of the music therapy group improved compared to before treatment (P<0.05), while the MoCA score, visual space and executive function, naming, attention, and orientation scores of the control group improved compared to before treatment (P<0.05). After treatment, the improvement in MoCA scores [5.0 (3.0, 6.0) vs. 2.5 (1.0, 4.0)], attention [1.0 (0.0, 1.0) vs. 0.0 (0.0, 1.0)], and abstract thinking scores [0.0 (0.0, 1.0) vs. 0.0 (0.0, 0.0)] in the music therapy group were better than that in the control group (P<0.05). There was no statistically significant difference in NIHSS, FMA, and MBI scores between the two groups of patients before treatment (P>0.05), and both groups improved after treatment compared to before treatment (P<0.05). After treatment, there was no statistically significant difference in the improvement of NIHSS, FMA, and MBI scores between the two groups of patients (P>0.05). Conclusions Compared with conventional rehabilitation therapy, training combined with music therapy is more beneficial for improving cognitive function in PSCI patients, especially in the cognitive domains of attention and abstract thinking. However, significant advantages have not been found in improving the degree of neurological impairment, limb motor function, and daily living activities.
ObjectiveTo investigate the effects of generic interleukin (IL)-17A gene knockout (IL-17AKO) on pancreatic and intestinal barrier on acute pancreatitis (AP) in mice. MethodsIL-17AKO mice and their wild type (WT) littermates were employed to induce AP using cerulein (CER) and sodium taurocholate (NaTC). In the CER-AP experiment, mice were randomly divided into three groups: WT control group, WT model group, and IL-17AKO model group (n=5). Mice in the model group were intraperitoneally injected with CER [50 μg/(kg·h), 7 injections], and control group received intraperitoneal injection the same amount of 0.9% NaCl. The mice were sacrificed at 12 hours after the first injection of CER. The levels of serum amylase, lipase and IL-6 were detected, and the pancreas was stained with hematoxylin-eosin (HE). In the NaTC-AP experiment, WT mice were randomly divided into sham group (n=3) and operation model group (n=6). Similarly, IL-17AKO mice were also randomly allocated to sham group (n=3) and operation model group (n=6). The mice in the sham group underwent a surgical procedure on the abdomen only, whereas in the model group, 50 μL 3.5% NaTC dissolved in saline solution was pumped into the pancreatobiliary duct. Serum amylase, lipase, and IL-6 levels were detected. Pancreas was stained with HE, and intestine was stained with Alcian blue-periodic acid-Schiff, Dolichos Biflorus Agglutinin and bacteria fluorescence in situ hybridization. ResultsIn the CER-AP experiment, there were no significant differences in serum amylase, lipase, IL-6, and pathological changes including edema, inflammation, necrosis, and total pathological score of the pancreas between IL-17AKO and WT mice (P>0.05). In the NaTC-AP experiment, compared to the WT model group, IL-17AKO did not significantly impact serum amylase, lipase, and pancreatic pathological changes (P>0.05). However, it did lead to an increased level of IL-6 (P<0.05), and showed no significant protective effect on intestinal injury in NaTC-AP. Compared to WT mice of sham group, IL-17AKO mice of sham group exhibited decreased expressions of glycosylated mucin in ileum and colon, disordered mucus layer structure, and increased bacterial invasion. ConclusionsIL-17AKO has no significant protective effect on pancreatic and intestinal barrier damage in AP mice. Furthermore, it was discovered that prior to modeling, IL-17AKO mice exhibited higher bacterial invasion, intestinal barrier disruption, and a systemic inflammatory response. These findings imply that IL-17A plays a crucial role in immune responses and the maintenance of physiological intestinal barrier function in mice.